Provider Demographics
NPI:1760447825
Name:BEDINGFIELD, ROBIN LEE (PT)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:LEE
Last Name:BEDINGFIELD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14861 N CAVE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-4909
Mailing Address - Country:US
Mailing Address - Phone:602-494-1548
Mailing Address - Fax:480-304-3438
Practice Address - Street 1:14861 N CAVE CREEK RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-4909
Practice Address - Country:US
Practice Address - Phone:602-494-1548
Practice Address - Fax:602-494-1548
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4329225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0461450OtherBCBS
AZZ77216Medicare PIN